Saturday, July 30, 2011

Don't Worry About the Government

*nod and chapeau to TW*

I see the clouds that move across the sky
I see the wind that moves the clouds away
It moves the clouds over by the building
I pick the building that I want to live in

I smell the pine trees and the peaches in the woods
I see the pinecones that fall by the highway
That's the highway that goes to the building
I pick the building that I want to live in

It's over there, it's over there
My building has every convenience
It's gonna make life easy for me
It's gonna be easy to get things done
I will relax alone with my loved ones

Loved ones, loved ones visit the building,
take the highway, park and come up and see me
I'll be working, working but if you come visit
I'll put down what I'm doing, my friends are important

Don't you worry 'bout me
I wouldn't worry about me
Don't you worry 'bout me
Don't you worry 'bout me

I see the states, across this big nation
I see the laws made in Washington, D.C.
I think of the ones I consider my favorites
I think of the people that are working for me

Some civil servants are just like my loved ones
They work so hard and they try to be strong
I'm a lucky guy to live in my building
They own the buildings to help them along

It's over there, it's over there
My building has every convenience
It's gonna make life easy for me
It's gonna be easy to get things done
I will relax along with my loved ones

Loved ones, loved ones visit the building
Take the highway, park and come up and see me
I'll be working, working but if you come visit
I'll put down what I'm doing, my friends are important

I wouldn't worry 'bout
I wouldn't worry about me
Don't you worry 'bout me
Don't you worry 'bout me...

Friday, July 29, 2011

Major Stupidity

Major Stupidity:                                      

Most of the morning and much of the afternoon was dedicated to diuresis, and there was great success in that endeavor, with fifteen trips to the bathroom ending in the suspicion of ankles down there where the leg ends.  Oh, and all my rings fell off!  [I wear three at all times.  Unless they fall off, willful little Tolkien-cribbers.]

The dregs of this Summer Viral Thingy had my throat sore enough that I did not want to drink, and the seemingly endless trips to the WC only reinforced that reticence.  Of the things I did manage to swallow, 50% was a strong Italian roast.  The remainder was split between a Diet Root Beer and a paltry 12 ounces of water.  This is noteworthy as I normally drink too much water (according to the Go-To-Guy Doc) -- roughly 4 litres. That's water on top of coffee and 1-2 diet decaffeinated drinks.  I could try to justify this weirdness but I won't.

We are out of yogurt.  This hardly ever happens.  I need yogurt in much the way I yearn for lots and lots of water.  I popped the foil on my last container last night only to find that it was... abnormal.  That's right, my last serving (or three) of yogurt came on Wednesday night.  Please keep in mind that I am continually on antibiotics and that my gut therefore has its own appreciation of my low fat plain yogurt concoctions.  I add a preferred amount of artificial sweetener and a dusting of cinnamon, or cocoa, or a spritz of vanilla extract... Add the current novel and you have my bedtime routine in its entirety.  Of course, "bedtime" around here is a laughing-stock of a notion.  Last night?  I kinda-sorta slept from 22:30 to midnight and then again from 03:00 - almost 05:00.  When exactly was bedtime?  Now, Fred sleeps like the proverbial rock as well as the fabled log.  He came to bed at 03:00, read precisely 5 pages of his book, and then rose from the bed at... drumroll, please... 15:30!  ManorFest 2011 is sapping the boy's strength.

Oh, you thought I had forgotten ManorFest 2011?  Not so, not so.  I am just at a loss for the best words to EXPLAIN it.  It hasn't exactly been your normal ManorFest...

Okay, so... the last of today's oddities.  That would be my handling of blood sugars.  I recently became a bit hot under the collar at the price of diabetic testing supplies (one of the greatest undisclosed absurdities of Medical Economics, probably because we poorer diabetics don't want to embarrass ourselves in front of the doctors, be they Go-To-Guys or not).  My anger resulted in the brilliant decision to not test as frequently as recommended.  Like sometimes not at all.  Which is what I did today, while not eating, not drinking, taking a humongous amount of Lasix, all the while still having my usual fever and *sweats*.

The sweats and the heat (Yes!  Even here in Tête de Hergé, it's freaking hot!) consorted to make me decidedly in need of a shower.  That's a major undertaking, so I filed it under "things to consider doing later, like, when I'm feeling really weak and shaky."

What?  Why, yes, I *did* take my insulin.  As scheduled.  Right on time!  Without eating, without testing.  What?  Why, yes, I *am* a Brainiac!

(Are you still with me?)

Fred, all perky-like after his marathon sleep session, heard me whining about not having any yogurt and cheerfully volunteered to make a yogurt run -- and I bet you've already guessed that one of the Cistercians' numerous cottage/mail order industries is yogurt-making!  Put Fred and Abbot Truffatore together on a Friday evening and you have a recipe for communion wine and politics.  Jump back, Jack!  Not that there's anything around here as exciting as the debt-ceiling debacle in The States, mind you.  We have, nonetheless, our own brand of titillating government scandals.  And they just go down better, says Fred and The Abbot, with communion wine on Friday nights.  Sometimes Tante Louise totters down to the Monks' Mess and joins in, but we won't talk about that.  It's okay, though -- she has a cell phone now so there won't be any more missed "911" calls.

Not that there's much of a need for "911" calls in Tête de Hergé.


Ah, alone in our apartment within the West Wing of Marlinspike Hall!  What a luxury.  Why not surprise Fred with a freshly scrubbed face (and feet, don't forget the feet, those things purported to be down there at the end of my legs... where are my legs?)?  Some fresh bright Gimp Clothes to tie my red face and purple feets together, and my goodness, he will faint from shock.

Which is, of course, what I did in the shower...
While alone in our apartment within the West Wing of Marlinspike Hall;
With La Bonne et Belle Bianca Castafiore on duty out in the middle of the ManorFest 2011 maze (as if she'd be of any help were she in the shower with me);
With Fred getting potted in the stolid arms of Tante Louise as the Sweet Boys sing the world a lullaby, and settle in for the night's silence.

I am fine.

Stupid, a little bruised, but fine.
Let's thank God for the shower chair, perfectly placed, as it happens.

Fred just made it home, fine purveyor that he is of all things I ever need.  I can hear him banging around in the Medieval Kitchen, shelving his purchases, feeding the felines, doing little jigs.  And Bianca's there, too -- determined to have a cup of tea despite the blanket of heat.  I think I hear The Cabana Boy, as well, humming along with the dread Jewel Song she never ceases to rehearse -- Sven's son.  Oh.  My.

Well, some catastrophes just have to happen, I guess.

I am going to finish chugging this water, then devour my sixth piece of hard, sweet candy, and go join the merriment.  Right after I verify a blood sugar above 38...

Potent Amalgam

A potent amalgam...

Oh, okay.  I ripped off "a potent amalgam" from a New York Times article about Chinese bloggers sticking it to that country's Rail Ministry (and government restrictions of free speech) in the wake of last week's crash:  In Baring Train Crash Facts, Blogs Erode China Censorship:
BEIJING — “After all the wind and storm, what’s going on with the high-speed train?” read the prophetic message posted last Saturday evening on the Chinese microblog Sina Weibo. “It’s crawling slower than a snail. I hope nothing happens to it.”
They were a few short sentences, typed by a young girl with the online handle Smm Miao. But five days later, the torrent that followed them was still flooding this nation’s Internet, and lapping at the feet of government bureaucrats, censors and the state-controlled press.

The train the girl saw, on a track outside Wenzhou in coastal Zhejiang Province, was rammed from behind minutes later, killing 40 people and injuring 191. Since then, China’s two major Twitter-like microblogs — called weibos here — have posted an astounding 26 million messages on the tragedy, including some that have forced embarrassed officials to reverse themselves. The messages are a potent amalgam of contempt for railway authorities, suspicion of government explanations and shoe-leather journalism by citizens and professionals alike.

The swift and comprehensive blogs on the train accident stood this week in stark contrast to the stonewalling of the Railways Ministry, already stained by a bribery scandal. And they are a humbling example for the Communist Party news outlets and state television, whose blinkered coverage of rescued babies only belatedly gave way to careful reports on the public’s discontent.

Jeezus.  Okay, the article was written by Michael Wines and Sharon LaFranière.

Oh, leave me alone! Some other people might have helped Shari and Mike: Jonathan Ansfield contributed reporting, and Adam Century, Li Mia, Li Bibo and Edy Lin contributed research.

This fit of honesty was brought to you by the nefarious and far-ranging moral influence of my Brother-Units.  One of them is a college English professor and the other maintains several blogs that are ruthlessly annotated with precise credits and hair-splitting acknowledgements of all that is minute and obscure.  

Grader Boob, the professor's chosen nickname, continues to require resuscitation several times in the course of each semester, continues to be shocked by encounters with plagiarism.

He has very little hair left and no shoulders (It's a family curse, these shoulder issues) due to the frequency with which his students go over his head (via his shoulders) to the milquetoast dean of their choice.

His department employs an online plagiarism detection service, something similar to Turnitin.  Otherwise, profs would be mired in the constant muck of "Did you write this?"  

Comprised of the OriginalityCheck, GradeMark and PeerMark programs, Turnitin provides a powerful solution for student writing. Using Turnitin, students upload their writing assignments and then instructors can check the papers for matching content from Turnitin’s extensive databases, review the paper for proper citations, provide digital marks on the student paper and assign papers for peer review. All of this takes place in a unified view of studentsʼ fully-formatted papers.

It may be news to some of you, but a hefty percentage of today's students are brazen. By "brazen" I mean they're *this* close to being serial con artists. Respect?  Don't count on it.  Intellectual curiosity?  Huh?  Critical thought?  Meh.  Work ethic?  Is this gonna be on the exam?

I'm out of the education game now [except for some private endeavors] but get just enough of a fix from Grader Boob's frantic emails to stave off major withdrawal symptoms.  Absent word from him, Fred knows to summon the monks, who toss me on the stretcher they make of their sturdy broadcloth skirts and rush me to one of the monastery's Indoctrination Classrooms.  I can be briefly revived by the chemical scent of a dry-erase marker gently shoved up my left nare.  Folklore has it that if a substantial pinch of pure ground calcium sulfate (or calcium carbonate) is placed between cheek and gum, an instantaneous cure may be effected -- but finding pure samples of these increasingly rare compounds is nigh unto impossible.


I just spent an irretrievable amount of precious time reviewing images and related articles culled by a search for "monastery classrooms." Yes, it *is* embarrassing to be caught without a snap of our neighbor Cistercians' Instruction Cells but the rich rewards of the search have me feeling all sweet and nice-like.  I mean, how can you not love something like this article from China Tibet Online, announcing the inauguration of the Sakya monastery's new site:

The new site to the monastery of Sakya has been built since May, 2005 with the investment of 9.62 million yuan and was totally completed this year. In the morning of Sept.5th, the inauguration of the new site is held lively. The new site is enlarged from the old one.Every year, Sakya Monastery enrolls new students once. For these students in the monastery, a study period of six to nine years is demanded. After the completion of the study, 7-year self-cultivation must be made. All including the study, the accommodation, the food are free. A big debate examination on Buddhism theory will be held every summer and every winter respectively.Corresponding diplomas will be given to students who finish the different-stage study. The monastery of Sakya has eight departments with its own classroom. Library, computer room, newsroom, and more rooms for students and teachers.

Shoot, I would PAY good money (non-US, I'm thinkin') to teach a classroom full of students planning on a 7-year period of contemplation after the completion of their formal education.

Hmmm.  Even my favorite segue (a cheery and cheerful "Anyway...") cannot save this post.  

Anyway... back to Brother-Unit Grader Boob and his tireless battle to educate the 18 - 22 year old youth of his state.  As luck would have it, much of the back-and-forth he must engage in over grading, attendance, do-overs, make-up work, and yes, plagiarism, is captured in priceless emails.

Let's revisit that amazing exchange of ideas that took place between Grader Boob and Johnny back in the Fall semester of 2008, shall we?
Dear Mr. X:  i was reading the comments for my 2nd draft and realized that the only reason why i received such a low grade in the paper was because you were part of the audience being attacked. in your "opinion", the whole paper was illogical and that's because you do not agree with my point of view and do not see it from my perspective. i did not mean to take it this far. I was expressing how i feel and obviously did not anticipate the consequences.With all due respect sir, my logic and point of view stands and i won't change anything. i will oversee the grammatical and MLA format errors but that is it. this paper was not a A+ but it certainly wasn't a D- either.Now that i've seen the expression i got out of you, i find it to be the best paper i've written yet. it was exactly how i expected the attacked audience to react. Now i have the outmost respect for you as a professor, thats why i recommend you read the paper over, put your feelings aside and give me the grade i deserve. in the case this project cause me to fail this class, I will take the appropriate action and take it to your supervisor and make my case. please do not take this as a threat, look inside yourself and think about this for a while. i am not going to rewrite this paper because you were offended sir, i can only sincerely apologize. i may have bad grammar skills or whatever but a stupid kid, i am not sir. Thank you.[Johnny]

Hi [Johnny]--You're being naive if you think that I get offended by a paper criticizing my generation. I read and grade each paper from the perspective of an academic audience.It is, of course, your option not to make any changes in your paper; it is, after all, your paper.But you've already seen the grade that that paper will receive.I wouldn't anticipate any change in that grade unless there are viable revisions in the final draft.
Mr. X

hello again SIR.Guess we gonna have to do this dance because my decision stand. we have two choices: we can schedule a meeting and i will make my case before you or i can wait until you give me the D than go straight to the dean or whoever is responsible for overseeing this matter. i may competely be naive sir... but i'm confident in my logic. im betting the majority who argue for our generation got this grade and thats why you brought the Bloom triangle BS to class the other week. i know u thinking about me wasting your time, i spent well over 6 hours on the assignment which you have assigned so id say i deserve a bit of ur time. therefore i suggest we try the first option.... [Johnny]
        Hi [Johnny]--
My office hours are listed on the syllabus. Feel free to swing by--either with the draft you have or with the final version of the paper.Be sure to correct the grammar errors before coming by. That should save us a lot of time.Mr. X

Poor Johnny. Poor Mr. X.
Myself?  I lack Grader Boob's infinite capacity for loving patience and his apparent aspiration to be a footnote to the Book of Job.  Also, I used to throw things at my students.  Were he one of mine, Poor Johnny might well be writing his apologies from the Student Infirmary.     

Officially, Grader Boob's large public university has a zero tolerance policy on plagiarism and cheating, in general.  In actuality, its enrollment numbers are in such decline that it covets every precious FreshPerson.  Hence my brother's lack of hair and sagging shoulders.  He's ridiculously dedicated to the idea that only good can come from relationship and dialogue, and despite year's of their abuse, is shocked whenever a Student-In-Big-Trouble fails to attend either office hours or a polite summons to appear.  He would prefer, he says, to work things out.  Indeed, if Johnny or Jane Plagiarist would just show the hell up, he's been known to allow the little reprobate the opportunity to re-write their composition/research paper/exam on the spot and, thereby, turn a zero into a sixty.  He double-majored in Math as an undergrad, so when he tells them that "a zero doesn't average well when calculating a grade average," I guess he knows whereof he speaks.

It was a rare moment of weakness when Grader Boob let slip that sometimes he'd be grateful for even a plagiaristic impulse, anything to reflect, well, verifiable consciousness.  I, of course, immediately published the relevant fragments of his 2009 email right here on the cutting edge elle est belle la seine la seine elle est belle blog:

One of his writing assignments for his Freshman comp students involved song analysis. Sorry to say, Grader Boob notes that, "apparently, the idea of a thesis merging literary and rhetorical analysis escapes most of my writers."  He offered the following quote from a student paper as clarification:
"Marley was a Jamican who sometimes visited the island of Hadee."

Words are such wonderful things, and power.  Like everyone with a passion, I fail to understand people who don't share mine, who don't understand the radical nature of speech and therefore want to speak well.

When the paucity of pay at the university level of education moved me from an ivory tower to an inner city public high school for the last few years of my career, I was excited, thrilled at the opportunity to effect change, to make a difference -- to be a très cool recasting of Poitier's Mr. Thackeray, with Alanis Morissette singing "To Madame, With Love." 

You can stop jiggling with laughter any time, okay?

Right... So I didn't make it past the first day before being initiated into the concept of "oh no you didn't." As in:  I know you didn't just touch me.  As in:  I know you don't think I am going to do this work.  As weeks and months went by, "oh no you didn't" only gained in textual complexity.

It was something of a surprise to see the nonchalant, smiling faces when I passed out Deficiency Notices at midterm.  Curious, I inquired what they thought the reaction at home to the notices might be.  So it was that I first learned about Failure to Educate lawsuits.  Go ahead and fail us, my merry high schoolers' taunted -- My Momma will sue your ass for Failure to Educate.

Grader Boob I am not. He would probably find an exciting opportunity for a writing assignment in that threat of legal action. Even when a student followed that up with "And I guess I'd have to take you out, Ms. Madam," my brother would feel delighted by his invitation to dinner.  [HINT:  Not an invitation to dinner.]

I miss those kids.  

I survived -- and occasionally thrived -- under their tutelage.  And I like to think that they are out there, Ms. Madam's secret army, stealthily spreading critical acumen with their original, pristine prose.

Embarrassing, praising, consorting, admonishing, working, helping, advocating social change, even threatening rhetoric and persuasion: a potent amalgam.

Ms. Madame's Best

Thursday, July 28, 2011

Lindsey Baum -- Two properties being searched

Grays Harbor County sheriff's deputies and FBI agents are searching two properties in McCleary for a girl who disappeared more than a year ago while walking home from a friend's house. Chief Criminal Deputy Dave Pimintel says detectives served search warrants Tuesday for the two locations - a house and a storage area. Pimentel says the search is similar to several others that have taken place in and around McCleary over the past 11 months. No arrests have been made and police have never identified a suspect in the disappearance of Lindsey Baum who was 10 when she went missing in June of last year. A $30,000 reward is offered for information to solve the case.

Correction:  Lindsey Baum has been missing for over 2 years.  In McCleary, Washington, around 9:15 pm on June 26, 2009, she disappeared somewhere in the 4-block stretch between her friend's house and her home.  She's now 13. The reward for information is now at $35,000.


ROS: Mitochondrial Dysfunction in CRPS

Here's a clue as to how scientistic I am, versus, say, those gifted and serious scientific types whose research into the mysteries of CRPS I am always appropriating for this blog:

Every time I encounter work that stems from findings based on the goopy gleanings from amputated limbs... I spend a good hour freaking out. 

The Amputated-CRPS-Limb One-Hour Freak Out has three stages:

1.  Maintaining steady pressure on the joystick such that my wheelchair goes round and round and round.  Duration is dependent on degree of battery charge.
2.  Going from one navigable end of Marlinspike Hall to another at my top speed of 4.25 mph, leaving an audible bloody trail of alphabet and punctuation marks in bolded cursive typeface, often in the form of "Ewwwww!!!!" -- although "Bleckkkkk!!!!" is also common.
3.  Nearly silent weeping, face buried in Aunt Jewel's beautiful Plauen lace wedding hankie.
If the reference to amputation occurs in the course of a doctor's visit and references my own limbs, I don't have the luxury of The Manor's airy venues, of course, so I go shopping -- for heat, for hot things, for unnaturally red Serranos.

This time, we are considering separated limbs in order to assess mitochondrial dysfunction in skeletal muscle tissue, something that apparently cannot be done from ordinary surgical detritus or using biopsies from living, oxygenated flesh. 

Ewwwww!!!! Bleckkkkk!!!!

Skeletal muscle stained for both cytochrome oxidase (COX) and succinic dehydrogenase (SDH), two mitochondrial respiratory
chain enzymes. Fibers that stain only for SDH and are COX-negative appear blue. Original magnification X 50.

Volume 15, Issue 7
Pages 708-715, August 2011.

Edward C.T. Tan, Antoon J.M. Janssen, Peggy Roestenberg, Lambert P. van den Heuvel, R. Jan A. Goris, Richard J.T. Rodenburg

ABSTRACT:  Reactive oxygen species (ROS) * are known to be involved in the pathophysiology of complex regional pain syndrome type I (CRPS I). Since the mitochondrial respiratory chain is a major source of ROS, we hypothesized that mitochondria play a role in the pathophysiology of CRPS I. The hypothesis was tested by studying mitochondrial energy metabolism in muscle tissue from amputated limbs of CRPS I patients. We observed that mitochondria obtained from CRPS I muscle tissue displayed reduced mitochondrial ATP production and substrate oxidation rates in comparison to control muscle tissue. Moreover, we observed reactive oxygen species evoked damage to mitochondrial proteins and reduced MnSOD levels. It remains to be established if the mitochondrial dysfunction that is apparent at the end-stage of CRPS I is also present in earlier stages of the disease, or are secondary to CRPS I. The observation of a reduced mitochondrial energy production combined with reactive oxygen species induced damage in muscle tissue from CRPS I patients warrants further studies into the involvement of mitochondrial dysfunctioning in the pathophysiology of CRPS.

1.Choksi KB, Boylston WH, Rabek JP, Widger WR, Papaconstantinou J. Oxidatively damaged proteins of heart mitochondrial electron transport complexes. Biochim Biophys Acta. 2004;1688:95–101MEDLINE

2.Clanton TL. Hypoxia-induced reactive oxygen species formation in skeletal muscle. J Appl Physiol. 2007;102:2379–2388
3.Cooperstein SJ, Lazarow A. A microspectrophotometric method for the determination of cytochrome oxidase. J Biol Chem. 1951;189:665–670MEDLINE

4.De Mos M, de Bruijn AG, Huygen FJ, Dieleman JP, Stricker BH, Sturkenboom MC. The incidence of complex regional pain syndrome: a population-based study. Pain. 2007;129:12–20Abstract
Full Text
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5.Dielissen PW, Claassen AT, Veldman PH, Goris RJ. Amputation for reflex sympathetic dystrophy. J Bone Joint Surg Br. 1995;77:270–273
6.Eisenberg E, Shtahl S, Geller R, Reznick AZ, Sharf O, Ravbinovich M, et al. Serum and salivary oxidative analysis in complex regional pain syndrome. Pain. 2008;138:226–232Abstract
Full Text
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7.Fischer JC, Ruitenbeek W, Trijbels JM, Veerkamp JH, Stadhouders AM, Sengers RC, et al. Estimation of NADH oxidation in human skeletal muscle mitochondria. Clin Chim Acta. 1986;155:263–273MEDLINE

8.Goris RJ. Reflex sympathetic dystrophy: model of a severe regional inflammatory response syndrome. World J Surg. 1998;22:197–202MEDLINE

9.Haas RH, Parikh S, Falk MJ, Saneto RP, Wolf NI, Darin N, et al. The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008;94:16–37CrossRef

10.Heerschap A, den Hollander JA, Reynen H, Goris RJ. Metabolic changes in reflex sympathetic dystrophy: a 31P NMR spectroscopy study. Muscle Nerve. 1993;16:367–373CrossRef

11.Higashimoto T, Baldwin EE, Gold JI, Boles RG. Reflex sympathetic dystrophy: complex regional pain syndrome type I in children with mitochondrial disease and maternal inheritance. Arch Dis Child. 2008;93:390–397CrossRef

12.Ingman M, Gyllensten U. mtDB: Human Mitochondrial Genome Database, a resource for population genetics and medical sciences. Nucleic Acids Res. 2006;34:D749–D751CrossRef

13.Janssen AJ, Trijbels FJ, Sengers RC, Smeitink JA, van den Heuvel LP, Wintjes LT, et al. Spectrophotometric assay for complex I of the respiratory chain in tissue samples and cultured fibroblasts. Clin Chem. 2007;53:729–734MEDLINE

14.Janssen AJ, Trijbels FJ, Sengers RC, Wintjes LT, Ruitenbeek W, Smeitink JA, et al. Measurement of the energy-generating capacity of human muscle mitochondria: diagnostic procedure and application to human pathology. Clin Chem. 2006;52:860–871MEDLINE

15.Klimova T, Chandel NS. Mitochondrial complex III regulates hypoxic activation of HIF. Cell Death Differ. 2008;15:660–666CrossRef

16.Lowry O, Rosebrough N, Farr A, Randall R. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951;193:265–275MEDLINE

17.Mersky H, Bogduk N, editors. Classification of chronic pain: description of chronic pain syndromes and definitions of terms. Seattle: IASP Press; 1994.
18.Perez RS, Zuurmond WW, Bezemer PD, Kuik DJ, van Loenen AC, de Lange JJ, et al. The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study. Pain. 2003;102:297–307Abstract
Full Text
Full-Text PDF (136 KB)

19.Robinson JN, Sandom J, Chapman PT. Efficacy of pamidronate in complex regional pain syndrome type I. Pain Med. 2004;5:276–280MEDLINE

20.Rodenburg RJ. Biochemical diagnosis of mitochondrial disorders. J Inherit Metab Dis 2010 [epub, PMID: 20440652].
21.Solaini G, Baracca A, Lenaz G, Sgarbi G. Hypoxia and mitochondrial oxidative metabolism. Biochim Biophys Acta. 2010;1797:1171–1177
22.Srere PA. Citrate synthase, EC, citrate oxaloacetate lyase (CoA-acetylating). Methods Enzymol. 1969;13:3–11CrossRef

23.Stanton-Hicks M, Janig W, Hassenbusch S, Haddox JD, Boas R, Wilson P. Reflex sympathetic dystrophy: changing concepts and taxonomy. Pain. 1995;63:127–133Abstract
Full-Text PDF (640 KB)

24.Tan EC, Ter Laak HJ, Hopman MT, van GoorH, Goris RJA. Impaired oxygen utilization in skeletal muscle of CRPS I patients. J Surg Res 2010.
25.Tran de QH, Duong S, Bertini P, Finlayson RJ. Treatment of complex regional pain syndrome: a review of the evidence. Can J Anaesth. 2010;57:149–166CrossRef

26.van der Laan L, Goris RJ. Reflex sympathetic dystrophy. An exaggerated regional inflammatory response?. Hand Clin. 1997;13:373–385MEDLINE

27.van der Laan L, Ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJ. Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve. Neurology. 1998;51:20–25MEDLINE

28.Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993;342:1012–1016Abstract

29.Zheng XX, Shoffner JM, Voljavec AS, Wallace DC. Evaluation of procedures for assaying oxidative phosphorylation enzyme activities in mitochondrial myopathy muscle biopsies. Biochim Biophys Acta. 1990;1019:1–10MEDLINE

WARNING:  As I was trying to read about some of the terms and concepts involved in discussions of ROS, ischemia, and the role of impaired oxygenation in the CRPS disease process, I encountered some strange, highly-glossed "articles" on several "pain clinic" sites, apparently part of the bait to reel in patients for treatments using Direct Intravenous Ozone Therapy (DIV).  Please be careful and exercise good judgment!  Think "embolism," for example...

Wednesday, July 27, 2011

There and Back Again

We did it!  We made it!  Fred and I, with the assistance of the very good-natured Ruby the Honda CR-V, arrived at the oncology infusion clinic almost on time!  I'll knock off the use of these annoying exclamation marks now!

The next visit will be much easier, as I filled out a novella of forms and produced redundancies of documentation that were then both scanned into the electronic medical record *and* photocopied.  Since they had so well established the theme of overabundance, the unit clerk supplemented the scanned and photocopied photo ID with an impromptu Polaroid of my cushingoid charms. So much for that pesky rumor about how an Electronic Medical Record garners savings of money and time.

It looked to me like three different records were being compiled:  a shorthand cheat sheet for use by the nurses right then and there; an electronic collection of my data; and an old fashioned paper chart. 

Once that was done, along with signing myriad permissions to bill, resuscitate, and transfuse, we were escorted into one of those huge, pseudo-cozy rooms littered with options to lay down, recline or rock.  I was still in the process of transferring from my wheelchair to the recliner when a clipboard began hovering before my eyes, along with the nub of a pencil.

"You'd best get started on this questionnaire.  It takes a while."

I was still filling it out when we left, which is not as much of an impossibility as it might sound.

The Head Ketamine Dood over at the Catastrophic Hospital had insisted I get this damned port implanted in my chest and connected with that major vessel called the subclavian. "I'll allow you to get the first treatment via a standard i.v. but if you show up for the second one without an implanted port, I will not treat you.  You need a port anyway.  You'll thank me for it."

You would have done what my doctors and I did -- move heaven and earth to arrange a surgical consult, pre-admission testing, and surgery itself -- all while dealing with the strange new world of subanesthetic ketamine infusions, and all within seven days.

That casual requirement of his cost roughly $13,000.00. 

I found the BardPort Titanium Implant for sale on eBay for $75.00 -- under the Buy It Now option.  Shipping added a hefty $11.95.

Fred and I are avid Do-It-YourSelfers, and we figure we could have handled the whole implantation thing with a minimum of fuss and a modicum of sterility for about $200 bucks.  That doesn't include antibiotics and Infectious Disease guidance.

Anyway (my preferred segue), after finally getting ourselves comfortably plopped in cushy seating, and accessorized with another ream of paperwork, I figured we had come to the easy part.  The staff had other plans, though, and insisted on taking vital signs.

On the off chance that my temperature, pulse, oxygen saturation, and blood pressure would turn out to be within shouting distance of normal, I abstained from my usual preface explaining why my numbers would probably be a bit off.  It was early in the morning, how bad could things be?


Phone calls, facsimiles, and expert opinions were made and sought, each costing me something, I'm sure, and wasting more of the earth's resources as old charts were pulled and ink was jotted and blotted on Big Pharma scratch pads, gifts from Pfohnzon and MerZenOtt. 

Resources.  Lots and lots of resources, human, natural, and electronic, all to flush and heparinize a port.

We finally determined that I was not likely to die this morning, I tidied up the assertions on my questionnaire (SEX? Yes), the nurse pulled the privacy drape around our little triad of chairs, and we got started...

Right after she finished scanning my plastic armband and each of the supplies, from 20 gauge non-coring needles (of the wrong length) to the 5 cc syringe of saline (we ended up needing four of them). 

Fred and I had developed a skit designed to so impress and delight the nurses that they'd agree to train us in the sterile procedure so that we could do it at home in the future.  We didn't make it out of the witty prologue before our nurse -- still desperately scanning -- panned the performance. 

"You can't do this at home.  You just can't," she explained.

Fred waited a beat and said, "But the lobotomy went off without a hitch!"

You could hear the gurgling lungs of the jaundiced woman across the room from us, it was that quiet.  Fred promptly buried his nose in an Illustrated Giant Print New Testament ("Easy on the Eyes!").

Gloved and masked, the nurse made quick work of prepping the skin, and inserted the needle with confidence.  She attached the syringe with 5 cc of saline, pulling back to check for a blood return... and there wasn't one.  I knew there would not be one but had decided against wowing her with my prognostications.  Besides, it could happen.  It could.  One day, I will have a PICC or even this same port, and there will be a blood return.

I believe.

I did let her know that I was a "saline taster," and that I had not tasted the distinctive metallic remnants after the injection.  She countered with "but I know it's in there, I could feel the needle hit the back of the port."

I said, "I'm just sayin'.  You know?"

That's how we ended up needing extra syringes.  Which is why she had to do more scanning.  Eventually, we found common ground.  I tasted the saline afterglow and she was confident of her placement, even without a blood return.  "Ha!" she crowed.

Fred, who was paying attention despite the red-lettered Testament, took that as a cue to try again, so he sat up and yelled in her ear:  "But the lobotomy went off without a hitch!"

It's tough to read a face covered with a mask.

She slapped a band aid on me, disposed of her sharps, and threatened to introduce some sort of medical Drano into the port when I returned in 4-6 weeks.  "Next time?  There will be a blood return.  Know what I mean?"

She cut off my plastic ID bracelet, made a few notations on the back of some gauze packaging.

As we wove our way out of what was now a crowded room, I tried to smile and nod at the pretty sad looking slew of cancer patients being infused with poison, and Fred wondered, in a loud and unfocused sort of way, if they gave out tokens to cover parking expenses.

Like I said at the beginning:  We did it, we made it, and next time will be much easier.

Courtesy of BARD Nordic

Monday, July 25, 2011

Laughing and Crying: Congratulations in the Form of Liberal Guilt

"In order to justify their behavior, they turn their theories into dogmas, their bylaws into First Principles, their political bosses into Gods and all those who disagree with them into incarnate devils. This idolatrous transformation of the relative into the Absolute and the all too human into the Divine, makes it possible for them to indulge their ugliest passions with a clear conscience and in the certainty that they are working for the Highest Good. And when the current beliefs come, in their turn, to look silly, a new set will be invented, so that the immemorial madness may continue to wear its customary mask of legality, idealism, and true religion." 
-- Aldous Huxley, The Devils of Loudun, 1952, Harper and Brothers, NY, NY.)

I laughed and cried at the same time on viewing photos of the first same-sex couples to be married under the new law in New York.  The laughter came from happiness for them and -- I confess it:  satisfaction at the thought of how these pictures must stick in the craw of people clinging to the fringe on the far right of our sociopolitical fabric.  The tears came a little bit from happiness for the newlyweds, as well, but mostly it was sadness and shame (Yes, I am One of Those Types of Liberals).

Uh-oh. I feel a tangent coming on.

I googled "liberal guilt," and was appropriately distressed to find that the vast majority of articles turned up by the search discussed "white guilt." 

Allow me to invent a statistic:  99.2% of the articles morphed liberal into white within their first paragraph among those that were so formatted;  An impressive 99.5% of that .08% paragraphed remainder did not even bother with a transitional phrase or sentence, rendering white as synonymous with liberal.  The tautological shortcomings of this kind of wacky thesaurus work are obvious, but apparently not remarkably so.  As for the unparagraphed among the culled, they were predominantly contained in readers' commentary and tended to bring to mind certain unappealing aspects of a severe gastrointestinal flu.  It's all in my footnotes.

Preconditioned to wonder what was wrong with me, that I had not remembered (or had I forgotten?) that I was white while weeping tears of happiness over the newly married lesbian and gay couples in New York, I took a few minutes out to don a modified hair shirt (it's hot!) and to read up on Self-Loathing (it's de rigueur!). 

Then, as usual, I got angry -- and please don't throw some pithy analysis of what you think my anger means back at me, because you are bound to turn a fairly flat anger into some convex divergence of wavy rage.

Entry after entry assumed me a white male (they often forget "privileged," so I am adding it for them).  One of the odd things worth noting? Susan Sontag is often mentioned in the middle of all that chalky-white phallic superiority...


... though, granted, she can be irritating:  Remember when she "equated" Communism with Fascism? 

She said The Left had romanticized Communism in order to better demonize Fascism.  She further posited Fascism as not only possible within a Communist context but probable, famously calling this symbiosis "Fascism with a human face."

She was a let-the-chips-fall-where-they-may kind of girl.

Oh, puh-leeze.  I know that extant power structures are, in fact, white male structures that perpetuate the marginalization of The Scary Other.  Did you not pay attention when you read the first 899 posts that make up this blog?  Jeez.  You probably don't remember my favorite color, either.  All I am trying to say, in a desperate attempt to return to the topic at hand, is that words matter, and that the degree of precision we bring to those words matters as much as their primary definitions.

Anyway, my impromptu internet search results insist that were I all those things that go into making a liberal, my guilt would have as origin my hatred of my own race.  That not being so, all of it together begs the question of whether non-white and/or female people can be liberal.  Actually, it's petitio principii all over the darned place (Watch you don't get mud on your panty hose!) because I'm beginning to think that Women are categorically exempt from guilt, and Women of Color, doubly so!

Okay, okay, I confess. My female, socialist, and undoubtedly racist self has never before noticed the obvious, in-your-face, bait-and-switch feint that blithely makes white and male out of liberal.  My brain may well explode if forced to consider the implications of more adjectival qualifications -- feminist, hopelessly self-deprecating, intellectual, pleasingly plump, vegetarian, etc.

My moral senses are feeling kinda dulled.  And has anyone seen my legs? (That's an Inside Joke for the Faithful Few.)

We believe things that fly in the face of reasoned proof all the time.  Remember that 24 percent of Republicans say that President Obama “may be the Antichrist.” Even larger numbers continue to insist that he is Muslim, socialist [Don't I wish?], and foreign born. 

47% of Democrats have heard that Republicans may have a sense of humor.

At the end of my tangential voyage, I've decided that it is perfectly fine to use the term "liberal guilt" without addressing or incorporating the notion of "white guilt," as long as the speaker's capacity for racism is a given. 

I'm sending off for the rulebook.

Yes, I laughed and cried gazing at the photos of Phyllis Siegel and her happy wife Connie Kopelov, married at 9:02 Sunday morning.  They found each other late in life and have been together for 23 years.  Phyllis is 77 and Connie is 85 and usually in a wheelchair.  They were the first same-sex couple to wed in New York City.  Two grandmothers won the honors for the entire state, marrying just after midnight in Niagara Falls.  Kitty Lambert, 54, and Cheryle Rudd, 53, from Buffalo, have five children from previous marriages.

It's great to see how well revisionist explanations of homosexuality as a youthful hormonal confusion play out in real life!

One of the first endearing things I learned about my darling Fred, some odd 20 years ago, was that if asked whether or not he was gay, he always said "Yes, I am!"  [With an ear-to-ear smile.]  He figured that the person asking needed to learn and believe that gay and lesbian people are everywhere [And happy!] and that by saying he was gay, he was just helping progress along.  I decided to do the same thing... but no one has ever asked me whether I am a lesbian and it is against The Rules to volunteer misinformation.  No, you have to wait until the person demonstrates a fairly affable need to be mislead. 

Anyway.  In the wake of my happy tears [tinged with liberal guilt], I considered the following:

*DADT is on its final legs, all wobbly, it's demise scheduled for 20 September 2011. 

*In SIX states, then, gay men and women will be able to live as openly as they may die in service to their country: Connecticut, Iowa, Massachusetts, New Hampshire, New York, and Vermont.

*DOMA is about to fall, that fell creature born of the equally fell Bob Barr -- he has moved on, now employing his considerable time and talents toward helping Jean-Claude Baby Doc Duvalier.  Of course, in 2009, Barr publicly stepped away from the document he authored, anchoring his reversal in what he considers the act's ultimate failure -- that it is incompatible with the belief in "federalism and the primacy of state government over the federal."  That guy wears his heart on his sleeve.

Not quite enough to allow us all to sit back and murmur, "Good times," but it feels like the right direction in which to travel.  We can get there from here, it turns out, and, amazingly, I estimate that there is precisely where I want my burden of liberal guilt to fall from my shoulders.

I imagine the sound to be one big old KerPlunk, which, as aficionados of the game will recall, is also the sound of lost marbles.

Congratulations, Phyllis and Connie, and may you have continued long life and happiness together.

Sunday, July 24, 2011

Vanished With Beth Holloway: Lindsey Baum

In the final show of its first season, Vanished With Beth Holloway will feature the case of missing child Lindsey Baum.  Episode 10, "Baum; Hill" airs tomorrow night, Monday, July 25, 2001 on LIFE at 11 pm

Sadly, the TV Guide synopsis manages to accurately sum up all we know about Lindsey's disappearance, despite two years of searches, interviews, and thorough investigation:   [She is] a girl who disappeared while returning home from a friend's house.

Lindsey Baum turned 13 on July 7.  It's important to keep in mind the considerable changes in appearance that can happen, not just in the course of any two years, but in the course of these years, in particular.  Lindsey was just 10 when she disappeared on her way home from a friend's house on June 26, 2009 in the small and seemingly untroubled town of McCleary, Washington.

A $35,000.00 reward continues to be offered for information leading to her return.

At a gathering marking her birthday, Grays Harbor County Sheriff Mike Wheelan said: "We still have full time people devoted to it, the FBI still has full time people devoted to it. We have not given up, and this case has not gone cold, and we're going to continue working it."

Grays Harbor County Information Hot-line (Tip line) (866) 915-8299

CUE Center For Missing Persons -24 Hour Tip Line ( 910) 232-1687

You may leave a confidential tip HERE, at Help Find Lindsey Baum.


1-800-843-5678 (1-800-THE-LOST)

McCleary Police Department (Washington) 1-360-533-8765
Or simply call 911.

To read all posts from this blog relating to Lindsey Baum, click HERE.